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DSH380022Y SAMARITAN ALBANY GENERAL HOSPITAL (Active)
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Main Details
Name
SAMARITAN ALBANY GENERAL HOSPITAL
Subdivision Name
AGH Hospice Outpatient Coastal - AGH Hospice Outpatient Coastal
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH380022Y
Medicare Provider Number
380022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/5/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/19/2022
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Samaritan Albany General Hospital
DANIEL B. SMITH, VP FINANCE/CFO
(541) 768-5390
Primary Contact
Samaritan Lebanon Community Hospital
Daniel Rackham, Chief Executive Officer
(541) 451-7914
Addresses
Street Address
749 SW 11th St
Newport, OR 97365
Billing Address
Samaritan Health Services
PO Box 3000
Corvallis, OR 97339
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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